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Zhu W, Zhou X, Ren M, Yin W, Tang Y, Yin J, Sun Y, Zhu X, Sun Z. Process approach as a cognitive biomarker related to gray matter volume in mild cognitive impairment and Alzheimer's disease. BMC Neurol 2024; 24:199. [PMID: 38872077 DOI: 10.1186/s12883-024-03711-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 06/04/2024] [Indexed: 06/15/2024] Open
Abstract
BACKGROUND Process approach is valuable for memory assessment in Alzheimer's disease (AD) and mild cognitive impairment (MCI), yet its underlying mechanisms remain elusive. This study aims to synergize the process approach with brain structure analysis to explore both the discriminative capacity and potential mechanisms underlying the process approach. METHODS 37 subjects of MCI, 35 subjects of AD and 38 subjects of healthy control (HC) were included. The process approach in Auditory Verbal Learning Test (AVLT), including discriminability (A'), response bias (B"D), semantic clustering (LBCsem) and serial clustering (LBCser) was performed. The gray matter volume (GMV) was analyzed by voxel-based morphometry. Receiver operating characteristic (ROC) analysis and partial correlations were conducted to explore the value of the process approach and investigate the relationship between the process approach, traditional indices of AVLT and GMV. RESULTS ROC analysis showed the value of A', B"D and LBCser in differentiating MCI and AD. Combining AVLT-Immediately Recall (AVLT-IR) and LBCser showed a higher value in diagnosing MCI. Partial correlations revealed that in the MCI group, A' and B"D were mainly positively associated with GMV of the hippocampus and temporal lobe. CONCLUSION This study indicated that the process approach is a promising cognitive biomarker to detect MCI and AD.
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Affiliation(s)
- Wenhao Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Xia Zhou
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Mengmeng Ren
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Wenwen Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Yating Tang
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Jiabin Yin
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Yue Sun
- Department of Neurology, the Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xiaoqun Zhu
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China
| | - Zhongwu Sun
- Department of Neurology, the First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, Hefei, 230022, China.
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Schäfer S, Tröger J, Kray J. Modern scores for traditional tests - Review of the diagnostic potential of scores derived from word list learning tests in mild cognitive impairment and early Alzheimer's Disease. Neuropsychologia 2024; 201:108908. [PMID: 38744410 DOI: 10.1016/j.neuropsychologia.2024.108908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 05/11/2024] [Accepted: 05/11/2024] [Indexed: 05/16/2024]
Abstract
Episodic memory impairment is one of the early hallmarks in Alzheimer's Disease. In the clinical diagnosis and research, episodic memory impairment is typically assessed using word lists that are repeatedly presented to and recalled by the participant across several trials. Until recently, total learning scores, which consist of the total number of words that are recalled by participants, were almost exclusively used for diagnostic purposes. The present review aims at summarizing evidence on additional scores derived from the learning trials which have recently been investigated more frequently regarding their diagnostic potential. These scores reflect item acquisition, error frequencies, strategy use, intertrial fluctuations, and recall consistency. Evidence was summarized regarding the effects of clinical status on these scores. Preclinical, mild cognitive impairment and mild Alzheimer's Disease stages were associated with a pattern of reduced item acquisition, more errors, less strategy use, and reduced access of items, indicating slowed and erroneous encoding. Practical implications and limitations of the present research will be discussed.
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Affiliation(s)
| | | | - Jutta Kray
- Saarland University, Saarbrücken, Germany
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Andreatta Maduro P, Guimarães MP, de Sousa Rodrigues M, Pereira Rolim Coimbra Pinto AP, da Mota Junior AA, Lima Rocha AS, Matoso JMD, Bavaresco Gambassi B, Schwingel PA. Comparing the Efficacy of Two Cognitive Screening Tools in Identifying Gray and White Matter Brain Damage among Older Adults. J Aging Res 2024; 2024:5527225. [PMID: 38690079 PMCID: PMC11060871 DOI: 10.1155/2024/5527225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 05/02/2024] Open
Abstract
Background Ageing is associated with structural changes in brain regions and functional decline in cognitive domains. Noninvasive tools for identifying structural damage in the brains of older adults are relevant for early treatment. Aims This study aims to evaluate and compare the accuracy of the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA©) in identifying gray and white matter brain damage in older individuals with varying degrees of cognitive impairment. Methods Ninety older adults (62 women) with an average age of 69 ± 7 years were enrolled and categorized as having no cognitive impairment (NCI), mild cognitive impairment (MCI), or moderate cognitive impairment (MoCI). Magnetic resonance imaging (MRI) was utilized to assess the number, volume, and distribution of brain damage. The Fazekas and Scheltens scales were applied to the brain MRIs, and inferential statistics were employed to compare variables among the groups. Results Cognitive impairment was observed in 56.7% of the participants (95% confidence interval (CI): 46.4-66.4%), with thirty-six older adults (40%) classified as MCI and 15 (17%) as MoCI. Cognitive impairment and medial temporal lobe (MTL) atrophy were found to be associated (p=0.001), exhibiting higher mean volume scales of the MTL atrophied area in the MoCI group (p < 0.001). The MMSE accurately revealed MTL atrophy based on the Scheltens (p < 0.05) and Fazekas (p < 0.05) scales. At the same time, the MoCA accurately identified periventricular white matter (PWM) abnormalities according to the Fazekas scale (p < 0.05). Conclusions The MMSE and MoCA screening tools effectively identified gray and white matter brain damage in older adults with varying degrees of cognitive impairment. Lower MMSE scores are associated with MTL atrophy and lesions, and lower MoCA scores are related to PWM lesions. The concurrent use of MMSE and MoCA is recommended for assessing structural changes in distinct brain regions.
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Affiliation(s)
- Paula Andreatta Maduro
- Post-Graduation Program in Health Sciences (PPGCS), University of Pernambuco (UPE), Recife, PE 50100-130, Brazil
- Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil
- University Hospital of the Federal University of Vale do São Francisco (HU-UNIVASF), Brazilian Hospital Services Company (EBSERH), Petrolina, PE 56304-205, Brazil
| | | | - Mateus de Sousa Rodrigues
- Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil
- University Hospital of the Federal University of Vale do São Francisco (HU-UNIVASF), Brazilian Hospital Services Company (EBSERH), Petrolina, PE 56304-205, Brazil
| | - Ana Paula Pereira Rolim Coimbra Pinto
- University Hospital of the Federal University of Vale do São Francisco (HU-UNIVASF), Brazilian Hospital Services Company (EBSERH), Petrolina, PE 56304-205, Brazil
| | - Américo Alves da Mota Junior
- Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil
- University Hospital of the Federal University of Vale do São Francisco (HU-UNIVASF), Brazilian Hospital Services Company (EBSERH), Petrolina, PE 56304-205, Brazil
| | - Alaine Souza Lima Rocha
- Post-Graduation Program in Health Sciences (PPGCS), University of Pernambuco (UPE), Recife, PE 50100-130, Brazil
- Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil
- Department of Physical Therapy, Federal University of Ceará (UFC), Fortaleza, CE 60430-450, Brazil
| | - Juliana Magalhães Duarte Matoso
- Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil
- Department of Clinical Medicine, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Rio de Janeiro, RJ 20551-030, Brazil
| | - Bruno Bavaresco Gambassi
- Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil
- Post-Graduation Program in Management of Health Programs and Services (PPGGPSS), CEUMA University (UNICEUMA), São Luís, MA 65075-120, Brazil
| | - Paulo Adriano Schwingel
- Post-Graduation Program in Health Sciences (PPGCS), University of Pernambuco (UPE), Recife, PE 50100-130, Brazil
- Human Performance Research Laboratory (LAPEDH), UPE, Petrolina, PE 56328-900, Brazil
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Yao X, Yang G, Fang T, Tian Z, Lu Y, Chen F, Che P, Chen J, Zhang N. Brain-derived neurotrophic factor gene polymorphism affects cognitive function and neurofilament light chain level in patients with subcortical ischaemic vascular dementia. Front Aging Neurosci 2023; 15:1244191. [PMID: 37876876 PMCID: PMC10590892 DOI: 10.3389/fnagi.2023.1244191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Objective To investigate the effects of brain-derived neurotrophic factor (BDNF) gene polymorphism on cognitive function, neuroimaging and blood biological markers in patients with subcortical ischaemic vascular dementia (SIVD). Methods A total of 81 patients with SIVD were included. According to their BDNF gene polymorphism, the participants were divided into the Val/Val (n = 26), Val/Met (n = 35), and Met/Met (n = 20) groups. A comprehensive neuropsychological evaluation and multimodal brain MRI scan were performed. MRI markers for small vessel disease were visually rated or quantitatively analysed. Moreover, 52 patients were further evaluated with blood marker assays, including amyloid beta (Aβ), phosphorylated tau at threonine-181 (P-tau181), glial fibrillary acidic protein (GFAP), total tau (T-tau) and neurofilament light chain (NfL). Results There were no significant differences in demographics, disease duration or MRI markers of small vessel disease between the three groups. Compared with the Val/Val and Val/Met groups, the Met/Met group showed worse performance in the verbal fluency test and higher levels of plasma NfL. Conclusion The rs6265 polymorphism of the BDNF gene is associated with semantic language fluency in patients with SIVD. The Met genotype may be a risk factor for cognitive impairment and neuronal injury.
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Affiliation(s)
- Xiaojuan Yao
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Guotao Yang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, China
| | - Tingting Fang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhuo Tian
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Yunyao Lu
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Feifan Chen
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Ping Che
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingshan Chen
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Nan Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
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Bidzan L, Grabowski J, Przybylak M, Ali S. Aggressive behavior and prognosis in patients with mild cognitive impairment. Dement Neuropsychol 2023; 17:e20200096. [PMID: 37223838 PMCID: PMC10202333 DOI: 10.1590/1980-5764-dn-2020-0096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/08/2021] [Accepted: 05/07/2021] [Indexed: 05/25/2023] Open
Abstract
The diagnosis of mild cognitive impairment (MCI) is associated with an increased risk of developing dementia. When evaluating the further prognosis of MCI, the occurrence of neuropsychiatric symptoms, particularly aggressive and impulsive behavior, may play an important role. Objective The aim of this study was to evaluate the relationship between aggressive behavior and cognitive dysfunction in patients diagnosed with MCI. Methods The results are based on a 7-year prospective study. At the time of inclusion in the study, participants, recruited from an outpatient clinic, were assessed with Mini-Mental State Examination (MMSE) and the Cohen-Mansfield Agitation Inventory (CMAI). A reassessment was performed after 1 year using the MMSE scale in all patients. The time of next MMSE administration was depended on the clinical condition of patients took place at the end of follow-up, that is, at the time of diagnosis of the dementia or after 7 years from inclusion when the criteria for dementia were not met. Results Of the 193 patients enrolled in the study, 75 were included in the final analysis. Patients who converted to dementia during the observation period exhibited a greater severity of symptoms in each of the assessed CMAI categories. Moreover, there was a significant correlation between the global result of CMAI and the results of the physical nonaggressive and verbal aggressive subscales with cognitive decline during the first year of observation. Conclusions Despite several limitations to the study, aggressive and impulsive behaviors seem to be an unfavorable prognostic factor in the course of MCI.
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Affiliation(s)
- Leszek Bidzan
- Medical University of Gdańsk, Faculty of Medicine, Department of Developmental, Psychotic and Geriatric Psychiatry, Gdańsk, Poland
| | - Jakub Grabowski
- Medical University of Gdańsk, Faculty of Medicine, Department of Developmental, Psychotic and Geriatric Psychiatry, Gdańsk, Poland
| | - Mateusz Przybylak
- Medical University of Gdańsk, Faculty of Medicine, Department of Developmental, Psychotic and Geriatric Psychiatry, Gdańsk, Poland
| | - Shan Ali
- Medical University of Gdańsk, Faculty of Medicine, Department of Developmental, Psychotic and Geriatric Psychiatry, Adult Psychiatry Student’s Scientific Circle, Gdańsk, Poland
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Tian R, Zhang Y, Liu F, Xue X, Zhang Y, Tian Z, Fang T, Fan R, Li Y, Zhang N. A neuropsychological profile and its correlation with neuroimaging markers in patients with subcortical ischaemic vascular dementia. Int J Geriatr Psychiatry 2023; 38:e5900. [PMID: 36862560 DOI: 10.1002/gps.5900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
OBJECTIVES Cognitive and neuroimaging assessments are still the main clinical practice methods for screening and diagnosing vascular dementia (VaD) patients. This study aimed to establish the neuropsychological characteristics of mild-to-moderate subcortical ischaemic vascular dementia (SIVD) patients, find an optimal cognitive marker for differentiating them from Alzheimer's disease (AD) patients, and explore the correlation between cognitive function and total small vessel disease (SVD) burden. METHODS SIVD (n = 60) and AD (n = 30) patients and cognitively unimpaired healthy controls (HCs; n = 30) were recruited from our longitudinal MRI AD and SIVD study (ChiCTR1900027943) and received a comprehensive neuropsychological assessment and a multimodal MRI scan. Cognitive performance and MRI SVD markers were compared between groups. Combined cognitive scores were established for differentiating between SIVD and AD patients. Correlations between cognitive function and total SVD scores were analysed in dementia patients. RESULTS SIVD patients showed poorer performance in information processing speed and better performance in memory, language, and visuospatial function than AD patients, although all cognitive domains were impaired in both groups compared with HCs. Combined cognitive scores showed an area under the curve of 0.727 (95%CI 0.62-0.84, p < 0.001) for differentiating SIVD and AD patients. Auditory Verbal Learning Test recognition scores were negatively correlated with total SVD scores in SIVD patients. CONCLUSIONS Our results suggested that neuropsychological assessments, specifically combined tests including episodic memory, information processing speed, language and visuospatial ability, are useful in the clinical differentiation between SIVD and AD patients. Moreover, cognitive dysfunction was partly correlated with MRI SVD burden in SIVD patients.
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Affiliation(s)
- Rui Tian
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Yanxin Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Fang Liu
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Xinran Xue
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China.,Department of Neurology, The Third Central Hospital, Tianjin, China
| | - Yutong Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhuo Tian
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Tingting Fang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Ruxue Fan
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuan Li
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Nan Zhang
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China.,Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
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Spatiotemporal EEG Dynamics of Prospective Memory in Ageing and Mild Cognitive Impairment. Cognit Comput 2022. [DOI: 10.1007/s12559-022-10075-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Prospective memory (PM, the memory of future intentions) is one of the first complaints of those that develop dementia-related disease. Little is known about the neurophysiology of PM in ageing and those with mild cognitive impairment (MCI). By using a novel artificial neural network to investigate the spatial and temporal features of PM related brain activity, new insights can be uncovered. Young adults (n = 30), healthy older adults (n = 39) and older adults with MCI (n = 27) completed a working memory and two PM (perceptual, conceptual) tasks. Time-locked electroencephalographic potentials (ERPs) from 128-electrodes were analysed using a brain-inspired spiking neural network (SNN) architecture. Local and global connectivity from the SNNs was then evaluated. SNNs outperformed other machine learning methods in classification of brain activity between younger, older and older adults with MCI. SNNs trained using PM related brain activity had better classification accuracy than working memory related brain activity. In general, younger adults exhibited greater local cluster connectivity compared to both older adult groups. Older adults with MCI demonstrated decreased global connectivity in response to working memory and perceptual PM tasks but increased connectivity in the conceptual PM models relative to younger and healthy older adults. SNNs can provide a useful method for differentiating between those with and without MCI. Using brain activity related to PM in combination with SNNs may provide a sensitive biomarker for detecting cognitive decline. Cognitively demanding tasks may increase the amount connectivity in older adults with MCI as a means of compensation.
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Zhang W, Zheng X, Li R, Liu M, Xiao W, Huang L, Xu F, Dong N, Li Y. Research on nonstroke dementia screening and cognitive function prediction model for older people based on brain atrophy characteristics. Brain Behav 2022; 12:e2726. [PMID: 36278400 PMCID: PMC9660432 DOI: 10.1002/brb3.2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 07/12/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Brain atrophy is an important feature in dementia and is meaningful to explore a brain atrophy model to predict dementia. Using machine learning algorithm to establish a dementia model and cognitive function model based on brain atrophy characteristics is unstoppable. METHOD We acquired 157 dementia and 156 normal old people.s clinical information and MRI data, which contains 44 brain atrophy features, including visual scale assessment of brain atrophy and multiple linear measurement indexes and brain atrophy index. Five machine learning models were used to establish prediction models for dementia, general cognition, and subcognitive domains. RESULTS The extreme Gradient Boosting (XGBoost) model had the best effect in predicting dementia, with a sensitivity of 0.645, a specificity of 0.839, and the area under curve (AUC) of 0.784. In this model, the important brain atrophy features for predicting dementia were temporal horn ratio, cella media index, suprasellar cistern ratio, and the thickness of the corpus callosum genu. CONCLUSION For nonstroke elderly people, the machine learning model based on clinical head MRI brain atrophy features had good predictive value for dementia, general cognitive impairment, immediate memory impairment, word fluency disorder, executive dysfunction, and visualspatial disorder.
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Affiliation(s)
- Wei Zhang
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xiaoran Zheng
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Renren Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Meng Liu
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weixin Xiao
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lihe Huang
- Research Center for Ageing, Language and Care at Tongji University, Shanghai, China
| | - Feiyang Xu
- iFlytek Research, iFlytek Co. Ltd, Hefei, China
| | - Ningxin Dong
- Department of Radiology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yunxia Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Lou F, Yang G, Cai L, Yu L, Zhang Y, Shi C, Zhang N. Effects of age, sex, and education on California Verbal Learning Test-II performance in a Chinese-speaking population. Front Psychol 2022; 13:935875. [PMID: 36092060 PMCID: PMC9454604 DOI: 10.3389/fpsyg.2022.935875] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
The California Verbal Learning Test-Second Edition (CVLT-II), is a commonly used tool to assess episodic memory. This study analyzed learning and memory characteristics in a cognitively healthy Chinese population, as well as the effects of age, sex and education on CVLT-II factors. In total, 246 healthy people aged 20–80 years and 29 persons with multiple sclerosis (MS) were included in this study and completed the CVLT-II. Factors including total learning, learning strategy, serial position effects, short-delay free and cued recall, long-delay free and cued recall, repetitions and intrusions during recall, hits and false positives of recognition, and total recognition discriminability were calculated. The effects of age, sex and education on these factors were analyzed using ANCOVA or independent two-sample t-tests and further confirmed by multiple regression analysis. The regression-based normative data were then computed by the equivalent scores method. Moreover, differences in learning and memory were compared between persons with MS and age-, sex- and education-matched healthy individuals. Most CVLT-II factors significantly differed between different age and education groups; in particular, better performance in total learning, recall, semantic clustering and recognition was observed in the younger and more educated groups than in the older and less educated groups. Male participants showed higher recency effect scores, more repetitions and fewer hits than female participants. Compared with healthy individuals, persons with MS showed extensive impairments in memory processes, such as learning, recall, learning strategy and recognition (p < 0.05). These findings indicated that verbal learning and memory were highly dependent on age and educational level but not strongly affected by sex. The CVLT-II effectively assesses episodic memory impairment in the Chinese-speaking population.
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Affiliation(s)
- Fanghua Lou
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Tianjin Huang He Hospital, Tianjin, China
| | - Guotao Yang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, China
| | - Lihui Cai
- School of Electrical and Information Engineering, Tianjin University, Tianjin, China
| | - Lechang Yu
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Zhang
- Department of Neurology, Tianjin TEDA Hospital, Tianjin, China
| | - Chuan Shi
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- *Correspondence: Chuan Shi,
| | - Nan Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
- Nan Zhang,
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Sun W, Wu Q, Chen H, Yu L, Yin J, Liu F, Tian R, Song B, Qu B, Xing M, Zhang N. A Validation Study of the Hong Kong Brief Cognitive Test for Screening Patients with Mild Cognitive Impairment and Alzheimer’s Disease. J Alzheimers Dis 2022; 88:1523-1532. [PMID: 35811533 DOI: 10.3233/jad-220417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The Hong Kong Brief Cognitive Test (HKBC), a brief instrument designed to screen for cognitive impairment in older adults, has been validated in Cantonese-speaking populations and has shown better performance than the Mini-Mental State Examination (MMSE) in detecting both mild and major neurocognitive disorder (NCD). Objective: This study aimed to validate the HKBC for detecting patients with amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD) in a Mandarin-speaking Chinese population. Methods: Two hundred forty-eight patients with aMCI, 67 patients with mild AD and 306 healthy controls (HCs) were recruited for this study and completed both the HKBC and the MMSE. The performance of the HKBC and MMSE in distinguishing patients with aMCI from HCs and distinguishing patients with AD from patients with aMCI was compared in the whole population and in age- and education-stratified subgroups. Results: The optimal HKBC cutoff score for distinguishing patients with aMCI from HCs was 23, and the optimal cutoff for distinguishing patients with AD from patients with aMCI was 17. The HKBC significantly outperformed the MMSE at differentiating patients with aMCI from HCs in the whole population (z = 12.38, p < 0.01) and all subgroups stratified by age or education. Regarding the discrimination of patients with AD from patients with aMCI, the HKBC showed better performance than the MMSE in the oldest subgroup (z = 2.18, p = 0.03). Conclusion: The HKBC is a sensitive and specific screening tool for detecting aMCI and AD in the Chinese population across age groups and educational levels.
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Affiliation(s)
- Wenhao Sun
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Qiuyan Wu
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Huifeng Chen
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Lechang Yu
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Yin
- Community Health Service Center of Wudadao Street, Tianjin, China
| | - Fang Liu
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Rui Tian
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Bingbing Song
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Bingqian Qu
- Department of Neurology, Tianjin Medical University General Hospital Airport Site, Tianjin, China
| | - Mengya Xing
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
| | - Nan Zhang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
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Pike KE, Wright BJ, Kinsella GJ. Observed Strategies on Naturalistic Associative Memory Tasks in Healthy Older Adults and Amnestic Mild Cognitive Impairment. Exp Aging Res 2022; 49:226-243. [PMID: 35451919 DOI: 10.1080/0361073x.2022.2068327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Understanding the strategies people with amnestic mild cognitive impairment (aMCI) spontaneously use can inform targeted memory training. METHOD Strategy use was observed for 99 people with aMCI and 100 healthy older adults (HOA) on two memory tasks. RESULTS No differences were found between aMCI and HOA in the amount or types of strategies used, but strategy use varied with task. Association was more effective for one task, whereas on the other task, use of written notes or multiple strategies were detrimental to performance and related to poorer performance than active (spaced) retrieval, for aMCI. CONCLUSION Our findings suggest the importance of identifying ineffective habits, in addition to instruction in more beneficial approaches.
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Affiliation(s)
- Kerryn E Pike
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia.,John Richards Centre for Rural Ageing Research, La Trobe University, Wodonga, VIC, Australia
| | - Bradley J Wright
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Glynda J Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Jiménez-Sánchez L, Hamilton OKL, Clancy U, Backhouse EV, Stewart CR, Stringer MS, Doubal FN, Wardlaw JM. Sex Differences in Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:756887. [PMID: 34777227 PMCID: PMC8581736 DOI: 10.3389/fneur.2021.756887] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Cerebral small vessel disease (SVD) is a common cause of stroke, mild cognitive impairment, dementia and physical impairments. Differences in SVD incidence or severity between males and females are unknown. We assessed sex differences in SVD by assessing the male-to-female ratio (M:F) of recruited participants and incidence of SVD, risk factor presence, distribution, and severity of SVD features. Methods: We assessed four recent systematic reviews on SVD and performed a supplementary search of MEDLINE to identify studies reporting M:F ratio in covert, stroke, or cognitive SVD presentations (registered protocol: CRD42020193995). We meta-analyzed differences in sex ratios across time, countries, SVD severity and presentations, age and risk factors for SVD. Results: Amongst 123 relevant studies (n = 36,910 participants) including 53 community-based, 67 hospital-based and three mixed studies published between 1989 and 2020, more males were recruited in hospital-based than in community-based studies [M:F = 1.16 (0.70) vs. M:F = 0.79 (0.35), respectively; p < 0.001]. More males had moderate to severe SVD [M:F = 1.08 (0.81) vs. M:F = 0.82 (0.47) in healthy to mild SVD; p < 0.001], and stroke presentations where M:F was 1.67 (0.53). M:F did not differ for recent (2015-2020) vs. pre-2015 publications, by geographical region, or age. There were insufficient sex-stratified data to explore M:F and risk factors for SVD. Conclusions: Our results highlight differences in male-to-female ratios in SVD severity and amongst those presenting with stroke that have important clinical and translational implications. Future SVD research should report participant demographics, risk factors and outcomes separately for males and females. Systematic Review Registration: [PROSPERO], identifier [CRD42020193995].
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Affiliation(s)
- Lorena Jiménez-Sánchez
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Olivia K. L. Hamilton
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
| | - Una Clancy
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ellen V. Backhouse
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Catriona R. Stewart
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Michael S. Stringer
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Fergus N. Doubal
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Joanna M. Wardlaw
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, United Kingdom
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Hamilton OKL, Backhouse EV, Janssen E, Jochems ACC, Maher C, Ritakari TE, Stevenson AJ, Xia L, Deary IJ, Wardlaw JM. Cognitive impairment in sporadic cerebral small vessel disease: A systematic review and meta-analysis. Alzheimers Dement 2021; 17:665-685. [PMID: 33185327 PMCID: PMC8593445 DOI: 10.1002/alz.12221] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 02/08/2020] [Accepted: 05/10/2020] [Indexed: 01/09/2023]
Abstract
This paper is a proposal for an update on the characterization of cognitive impairments associated with sporadic cerebral small vessel disease (SVD). We pose a series of questions about the nature of SVD-related cognitive impairments and provide answers based on a comprehensive review and meta-analysis of published data from 69 studies. Although SVD is thought primarily to affect executive function and processing speed, we hypothesize that SVD affects all major domains of cognitive ability. We also identify low levels of education as a potentially modifiable risk factor for SVD-related cognitive impairment. Therefore, we propose the use of comprehensive cognitive assessments and the measurement of educational level both in clinics and research settings, and suggest several recommendations for future research.
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Affiliation(s)
- Olivia KL Hamilton
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Lothian Birth Cohorts, University of Edinburgh, 7 George Square, Edinburgh, UK, EH8 9JZ
| | - Ellen V Backhouse
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
| | - Esther Janssen
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
| | - Angela CC Jochems
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
| | - Caragh Maher
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
| | - Tuula E Ritakari
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
| | - Anna J Stevenson
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital Campus, Crewe Road, Edinburgh, UK, EH4 2XU
- Centre for Discovery Brain Sciences, University of Edinburgh, Hugh Robson Building, 15 George Square, Edinburgh, UK, EH8 9XD
| | - Lihua Xia
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, UK, EH8 9JZ
| | - Ian J Deary
- Lothian Birth Cohorts, University of Edinburgh, 7 George Square, Edinburgh, UK, EH8 9JZ
- Department of Psychology, University of Edinburgh, 7 George Square, Edinburgh, UK, EH8 9JZ
| | - Joanna M Wardlaw
- Centre for Clinical Brain Sciences, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Dementia Research Institute, University of Edinburgh, Chancellor’s Building, 49 Little France Crescent, Edinburgh, UK, EH16 4SB
- Lothian Birth Cohorts, University of Edinburgh, 7 George Square, Edinburgh, UK, EH8 9JZ
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Is semantic learning strategy an early clinical marker for amnestic mild cognitive impairment and Alzheimer's disease? Int Psychogeriatr 2019; 31:1695-1697. [PMID: 31856929 DOI: 10.1017/s1041610219001832] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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